Active NPI
Trinity Medical Care
- Internal Medicine Physician
- Lakewood, CA
National Provider Identifier
1992271597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- TRINITY MEDICAL CARE
- Practice address
- 3650 South St Ste 110
Lakewood, CA 90712-1534 - Phone
- (562) 531-6140
- Fax
- (562) 531-7404
- NPI assigned
- Oct 22, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Sam Abdelemelek, MD
- Title
- Owner
- Phone
- (562) 310-1795
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
3650 South St Ste 110
Lakewood, CA 90712-1534
Mailing address
5200 Clark Ave Unit 768
Lakewood, CA 90714-7037
Phone (562) 531-6140
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649414855 | Medicaid | CA |
National Provider Directory
National Provider DirectoryLocations
5200 Clark Ave
Unit 768
Lakewood, CA 90714
3650 South St
Ste 110
Lakewood, CA 90712
Phone (562) 531-6140
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540166400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1540166400000",
"number": "1992271597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5200 CLARK AVE UNIT 768",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907147037",
"telephone_number": "562-531-6140",
"fax_number": "562-531-7404"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3650 SOUTH ST STE 110",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907121534",
"telephone_number": "562-531-6140",
"fax_number": "562-531-7404"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TRINITY MEDICAL CARE",
"organizational_subpart": "NO",
"enumeration_date": "2018-10-22",
"last_updated": "2018-10-22",
"status": "A",
"authorized_official_last_name": "ABDELEMELEK",
"authorized_official_first_name": "SAM",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "562-310-1795",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1649414855",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lakewood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.